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Auscultation and Remote AI

Auscultation and Remote AI

By Mark Watts

Dr. Gil was reviewing a well-designed SMS (texting) communication system that allowed the response from the patient to be monitored by artificial intelligence triage software. He loved the idea and ability to launch a real time telehealth face-to-face consultation if needed within the application. “I really love this product, but can I measure something remotely to help me decide what advice to give?”

In my previous article I spoke of how an automated external defibrillators (AED), could instruct a lay person to shock a patient if needed. The sudden heart attack, a life or death event allows us to create a system in the AED to aid in a cardiac event. What would it take to help with respiratory events?

What if Dr. Gil could get a stethoscope to listen to lung and heart sounds remotely? Could he recommend to an asthmatic child’s parents what to do via telemedicine?

Auscultation is the action of listening to sounds from the heart, lungs and other organs – typically with a stethoscope. It takes quite a few listens before a practitioner can decide if the patient is healthy or not. It takes practice.

StethoMe aims to save you the time and practice needed to become a pro and interpret the data. You do not need the years and years of experience a pulmonologist must have to interpret the auscultation records. StethoMe tells you all a parent really wants to know whether your child’s respiratory sounds are healthy or not. And after consulting a doctor, you will be sure about what to do next.

It is frustrating for parents to see a child battling an illness and not to know how to help or how serious it is. After all, we just want to do everything we can for them. No wonder there are millions of unnecessary visits to the ER every year. So, an AI-powered stethoscope at one’s home could give a peace of mind to parents. In the long run it could also save time for doctors and money for hospitals.

A new and exciting idea in health technology for sure. So, how did they come up with it? And what lies ahead for this company?

“The idea comes from the co-founders of StethoMe – Dr. Honorata Hafke-Dys and Dr. Jędrzej Kociński. Both are scientists, but also parents who struggled with their children’s frequent respiratory tract infections. After going through this experience, Honorata and Jędrzej discussed the idea of a home stethoscope that could potentially change the lives of many families around the world,” explained Wojciech Radomski, CEO of StethoMe.

The Poland-based company’s software and device have already received the European CE Mark and are waiting for FDA approvals to expand into the United States. The smart stethoscope is aimed at parents with young children. When there is a sign of sickness, after a quick auscultation, the AI can help parents and doctors work as a team to decide on the next step.

But fear not, fellow adults, we do not have to feel left out. The company is working on algorithms for identifying respiratory sounds in adults and recognizing heart sounds as well.

The product comes with a quick start guide, the stethoscope and a charger cable. The design of StethoMe is light, wireless and minimalistic with a bright display. It is made from plastic, yet it doesn’t feel or look cheap. There are no buttons on the device, just a jack socket, so you just shake it gently to wake it up. It will re-enter sleep mode automatically when not used. You can tap the display to switch between auscultation modes or to turn it off.

The device works as a regular stethoscope without the app – you only need to plug in your headphones, and you are ready to go. To unlock its full potential, you will need to download the app (supports both iOS and Android). With headphones on, it is quite loud and, unfortunately, you cannot adjust the volume.

A parent would need to create an account and accept user permissions for the exciting part to begin. For the app to pair with your stethoscope, you will need Internet access, Bluetooth connection and location services turned on. I am not a big fan of providing more than necessary data to anyone. It would be a better user experience if we could choose not to give location permission.

The most important features of the StethoMe stethoscope include lung and heart examination, keeping record of medical history, artificial intelligence-based analysis and “full flexibility in terms of integration and API for the doctor’s analytical panel.”

I believe AI plays an important role in the future of medicine, stethoscopes and other medical inventions using neural networks could be as common and a basic part of your medicine cabinet as thermometers today. Let us see what this device can do, to prove my point!

Auscultation is made easy. First, you will be asked to set the age of the patient and choose whether you wish to auscultate the heart or lungs. The device automatically connects to the app. The instructions are easy to follow and there is always a picture to help you with every step. That is why setting the age of the patient was important during the first step. To make our lives a bit easier, the app shows us a picture of a child around the set age, with the points of auscultation indicated.

You will need to follow the animation on the screen and place the device on the skin for it to start recording. You do not have to push any buttons; the process is fully automatic. Auscultation can stop when the background noise is too loud. This could be a problem, especially with children feeling impatient and irritated.

After the whole process the app will immediately inform you if the child has abnormal (red) sounds or normal (green) results. The results are automatically analyzed and sent to the platform for doctors and parents to see in more detail.

It does not provide you with a diagnosis, but you can share the results with a pediatrician, and in case of abnormal sounds, they could ask to see the child in their office, in the ER or to stay at home and look for changes in their condition.

In the more detailed desktop version for doctors, we can also see the diagrams of the recordings, play back the sounds and find more information on the quality of the abnormalities. (StethoMe categorizes these sounds according to the European Respiratory Society’s guidelines as wheezes, fine or coarse crackles, and rhonchi.) On the diagram you will be able to see if these happen during inhalation or exhalation.

Changes and innovation do not seem to steer clear of pulmonology either. If a smart stethoscope goes mainstream, doctors will have more time to focus on patients who they really need to see in person. A universal standard in such a subjective examination format as auscultation might lead to patients receiving more precise care.

People do not like change. It is not any different in health care. It took plenty of time until the stethoscope, the symbol of health care, was accepted by the medical community back in the 19th century. The instrument was invented by French physician René-Théophile-Hyacinthe Laënnec, who published its description in 1819, but it took several decades until doctors started using it.

But when it comes to our comfort, fun or just a truly game-changing idea, we find it easier to welcome new inventions into our lives. A home stethoscope backed with AI could give parents an ease of mind, save children from an unnecessary trip to the doctor and assist health care providers to make the right call (and medical students to learn a bit quicker).

The current situation with AI and neural networks, digital health gadgets and the steady mindset change about telemedicine are all significant stepping stones to a better future. So, let us hope for a quicker change this time!

I think about the asthmatic children in smog-filled cities or areas with wildfires. I believe that a product like a home stethoscope backed with A.I. could make Dr. Gil and parents feel better about their caring and compassionate health care decisions.

Mark Watts is the enterprise imaging director at Fountain Hills Medical Center.

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